Limited information indicates that typical doses of velpatasvir produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants. If velpatasvir is used alone or in combination with sofosbuvir (Epclusa) or sofosbuvir and voxilaprevir (Vosevi), it is not a reason to discontinue breastfeeding. Hepatitis C is not transmitted through breastmilk and breastmilk has been shown to inactivate hepatitis C virus (HCV).[1–4] However, the Centers for Disease Control recommends that mothers with HCV infection should consider abstaining from breastfeeding if their nipples are cracked or bleeding. It is not clear if this warning would apply to mothers who are being treated for hepatitis C. Infants born to mothers with HCV infection should be tested for HCV infection; because maternal antibody is present for the first 18 months of life and before the infant mounts an immunologic response, nucleic acid testing is recommended.[1,4]
